Opinion – Eliza Mondegreen
American doctors are unnecessarily harming children
ELIZA MONDEGREEN – 5 July 2022 – Unherd
The Biden administration recently announced a plan to ban “conversion therapy” and dismantle barriers to “gender-affirming care” for transgender-identifying children and adolescents. A few days later, Congresswoman Pramila Jayapal introduced the “Transgender Bill of Rights” on Capitol Hill which sought to legislate what the Biden Administration proposed to impose by executive order.
On this issue, the Democratic Party assumes the mantle of righteousness. Who could oppose “life-saving” “gender-affirming care”? Who supports “conversion therapy”, which the Biden administration described as “a discredited and dangerous practice that seeks to suppress or change the sexual orientation or gender identity of LGBTQI+ people”?
The reality diverges sharply from the loaded language the Biden Administration deploys, lifting terms directly from the most radical trans activists occupying positions at the outermost extreme of an ongoing debate between different factions of gender clinicians.
The dispute over how best to treat gender-questioning children that the Biden Administration seeks to resolve by enshrining “gender-affirming care” and stigmatising “conversion therapy” boils down to whether or not clinicians regard the children in their care as exceptions to everything we know about child development, human biology, sexual orientation, and more. Attending closely to the language of the activists with whom the Biden Administration has sided provides a masterclass in how to manipulate language to normalise risky and invasive medical intervention on a class of people — children — who are widely understood to be unable to provide consent in other contexts.
For exploratory providers, a child’s transgender identification is the beginning of a clinical inquiry that will travel through the individual patient’s biography, their social context, and the templates the culture at large offers that young patients use to make sense of suffering. Nothing magical or transformative happens when a patient experiences gender dysphoria or expresses a transgender identity. Children and adolescents remain children and adolescents. Clinical practice does not overthrow itself when a young patient changes her pronouns.
For affirmative clinicians, on the other hand, the declaration of a transgender identity and the desire for a particular gender presentation suffice. That’s what affirmation means: no further inquiry required. A transfer of loyalty takes place when affirmative clinicians are confronted with “trans” children and adolescents: clinicians’ sense of responsibility shifts from the patient in front of them to the patient’s transgender “alter”. Doctor and patient then collude to slice and drug the patient’s body into compliance with the new identity regime.
Across the Atlantic, countries such as Sweden, Finland, and the United Kingdom are stepping back and shifting away from hormones and surgeries and toward exploratory psychotherapy as evidence of harm mounts. It’s remarkable that the United States government has chosen this moment to double down, without reference to serious inquiries underway at home and abroad…